Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.129298 | OH |
Y | 2080A0000X | Adolescent Medicine | 35.129298 | OH |
NPI | 1023435120 |
---|---|
Provider Name | Maria D Brown |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 22/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023435120 | (05) | OH |
H731810 | CGS - MEDICARE (01) | OH |